| NPI | 1639153687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME180350) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036106574) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2026-04-01 |